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Quality Management Program Goals for 2021

View quality management resources, including the 2020-member satisfaction survey, examples of 2020 HEDIS rates and examples of 2021 quality management goals.

Quality Management Program Goals

Health Partners Plans (HPP) has a quality management program to make sure that our members receive safe and effective clinical care that is timely and patient centered. Throughout the year, HPP monitors the delivery of health care to members and annually evaluates the entire program to determine if goals were met and define goals for the year ahead.

A sample of 2020 accomplishments:

  • HPP maintained accreditation status with the National Committee for Quality Assurance (NCQA) and NCQA Multicultural Health Care recognition
  • Met with all Patient-Centered Medical Home (PCMH) practice groups quarterly to review quality data improvement strategies
  • Continued provider monitoring to address quality of care issues and complaints
  • Continued a multidisciplinary workgroup for the Centers of Excellence (COE) for Opioid Used Disorder (OUD)
  • Timely submission of all regulatory required programs such as HEDIS, EQR, the process improvement plans, Patient Centered Medical Home (PCMH), Community Based Care Management (CBCM) and technical responses to the PA state contracted auditor, IPRO
  • Implemented a work from home strategy to maintain safety of staff while providing services to our members

Quality Management goals for 2021 and some specific objectives include:

  • Improve health outcomes through greater access to quality care
  • Improve HEDIS rates
  • Implement a workgroup to improve Hemoglobin A1c (HgA1c) results for African American members with an uncontrolled HgA1c
  • Improve member satisfaction with the plan and provider services
  • Continue post-visit member surveys to understand barriers to members’ satisfaction with their provider
  • Maintain National Committee for Quality Assurance (NCQA) accreditation
  • Educate all stakeholders on the 2021 NCQA Standards and Guidelines to maintain accreditation
  • Ensure member complaints and quality of care cases are opened and processed within specified timeframes
  • Address members’ needs from a cultural and linguistic perspective
  • Ensure contractual reports are received timely from delegated vendors
  • Process all credentialing and re-credentialing files within regulatory timelines
  • Continue reviewing prescription drug claims and monitoring opioid utilization to improve patient safety/cost effectiveness

For more information

For more details about all of HPP’s accomplishments, please call our Quality Management department at 215-991-4202.